title: Resolution of opioid-induced postoperative ileus in a newborn infant after methylnaltrexone.
abstract: Transient impairment of bowel function is a frequent and distressing problem in neonates on opioid-induced analgesia. Methylnaltrexone, a peripheral-acting μ-opioid receptor antagonist, has been studied in adults for the treatment of opioid-induced constipation in advanced illness and has been suggested as a promising therapeutic concept for reducing postoperative ileus. Here, we report on a newborn infant on fentanyl analgesia after major abdominal surgery with aggravated ileus. After 8 days of quiescent bowel, the patient's intestinal dysmotility resolved within 15 minutes after intravenous administration of methylnaltrexone (0.15 mg/kg body weight). Methylnatrexone was repeated daily until cessation of fentanyl administration. There were no signs of pain or opioid withdrawal.
authors.affiliation: Department of Neonatology, Charité University Medical Center, Berlin, Germany. lars.garten@charite.de
authors.forename: Lars
authors.initials: L
authors.lastname: Garten
authors.forename: Petra
authors.initials: P
authors.lastname: Degenhardt
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
mesh_terms: D001015:Aortic Arch Syndromes / Q000601:surgery; D003327:Coronary Disease / Q000150:complications / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation; D017809:Fatal Outcome; D005260:Female; D005283:Fentanyl / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007418:Intestinal Pseudo-Obstruction / Q000139:chemically induced / Q000188:drug therapy*; D009271:Naltrexone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009294:Narcotics / Q000009:adverse effects*; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications / Q000139:chemically induced / Q000188:drug therapy*; D000644:Quaternary Ammonium Compounds / Q000627:therapeutic use; D012074:Remission Induction
chemical_list: D009292:Narcotic Antagonists; D009294:Narcotics; D000644:Quaternary Ammonium Compounds; C032257:methylnaltrexone; D009271:Naltrexone; D005283:Fentanyl